The incidence of pressure ulcers in hospitalized patients is widely recognized. Less recognized is the incidence and cost of treatment of pressure ulcers resulting from surgery. The 1992 nationwide cost for the treatment of pressure ulcers in hospitalized patients was $836 million, according to the National Consensus Conference on Pressure Ulcers in Washington D.C. Research estimates indicate that on average 12 percent of all surgical patients suffer some degree of skin pressure injury. The proposed work is aimed to improve the standard of care by the development of a surgical support surface with improved pressure management, greater patient stability and integral heating and cooling. These characteristics are anticipated to decrease the incidence of surgically induced pressure and ulcers and reduce patient positioning time spent by operating room staff. The work will produce prototypes of static and dynamic air, fluid and foam hybrids, which may include pressure and temperature monitoring at the patient support interface. Pressure relieving performance of the prototypes will be evaluated using the Xsensor(tm) 2-dimensional capacitive pressure sensing system. Stability will be measured by displacement measurements on human subjects during operating room table tilt manipulations. Heating and cooling effectiveness will be measured using a standard thermal load and a thermistor array for temperature and time constant measurements. Patient comfort will be evaluated by comparing electromyographic signals from postural muscles of volunteer subjects lying on existing commercial and the prototype surfaces. PROPOSED COMMERCIAL APPLICATION: The results of this work are applicable to surgical support surfaces used on operating room tables and may have application to examination table surface, used more frequently. The results may also be applicable to stretchers and possibly hospital and nursing home beds.